Influenza （H1N1）2009 感染による小児入院肺炎例の解析―呼吸器合併症の有無による臨床的特徴―

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タイトル別名
  • Analysis of Inpatients with Pneumonia Due to Influenza(H1N1)2009 ―Clinical Aspects Based on the Presence or Absence of Respiratory Complications―
  • Influenza(H1N1)2009 カンセン ニ ヨル ショウニ ニュウイン ハイエンレイ ノ カイセキ : コキュウキ ガッペイショウ ノ ウム ニ ヨル リンショウテキ トクチョウ

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We retrospectively analyzed the clinical aspects of inpatients with pneumonia caused by influenza (H1N1) 2009 after classifying them into two groups based on the presence or absence of respiratory complications. <BR> The study population -121 (5.6%) of 1,777 subjects diagnosed with influenza (H1N1) 2009 using a rapid influenza diagnostic kit or real-time reverse-transcription PCR- were hospitalized from August 2009 to May 2010 as detailed from admission to discharge in hospital medical charts. Of these, 72 had respiratory symptoms and most -56, or 3.2%, of the total-were diagnosed with pneumonia in chest radiography. The mean age of those with pneumonia was 6.9 years, 35.7% had a history of bronchial asthma and 80.4% were admitted within three days of onset. Some 75% of those with pneumonia, or 42, had respiratory distress (SpO2 ≤ 93%) requiring supplementary oxygen. Significant lymphopenia and neutrophil increase were observed in blood tests of those admitted within three days of onset. Almost all were given an antiviral agent for 5 days. <BR> Among pneumonia cases, 14 (25%) also had severe respiratory complications such as pneumomediastinum and atelectasis, designated the complications group. They also had significantly lower oxygen saturation and significantly more elevated non-specific IgE on admission than those in the non-complications group (n=42). Those with complications were hospitalized for significantly longer, and were administered isopretenol. All inpatients with influenza (H1N1) 2009 were discharged as healthy. <BR> Based on our retrospectively analyzed results in those with influenza (H1N1)2009 pneumonia, we concluded that the following medical circumstances covered by the Japanese insurance system help lead to good outcomes : i) visiting the hospital soon after onset, ii) being diagnosed early using a rapid identification kit, iii) under-going systemic whole-body management, and iv) being administered antiviral and antibacterial agents.

収録刊行物

  • 感染症学雑誌

    感染症学雑誌 86 (1), 13-21, 2012

    一般社団法人 日本感染症学会

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